Medical insurance for every American is a creditable goal. Politicians at every level are lined up in support of it. But an equitable system of providing such coverage is not probable in our confused political climate.

San Francisco is poised to offer health care coverage to 82,000 residents, but the plan only fiddles approximately the edges of a failing system. What we need is a federally funded, complete plan of vouchers that provides basic health coverage for everyone.

Ideally, every person in America will have personal health care coverage from childhood, through school and a career, and into retirement. Coverage will no longer depend on employment or pre-existing conditions. Basic health care will be free, and additions to standard coverage will be obtainable for a price.